Valvular & structural heart diseaseResearch article
Surgical Bailout in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement
- Pooled patient-level analysis of 10 clinical studies (CENTER2)
Authors' conclusion
The incidence of surgical bailout is very low in the contemporary TAVR population. Mortality rates remain high among patients requiring surgical bailout during transfemoral TAVR, but this risk diminishes in patients surviving the postprocedural period.
Study context
- Population
- Patients undergoing transfemoral transcatheter aortic valve replacement (TAVR), 2007–2022
- Participants
- 24,010 patients · 10 clinical studies
- Comparison
- Surgical bailout vs no surgical bailout
- Surgical bailoutn = 125
- Outcome
- Incidence, trends and clinical outcomes of surgical bailout
Main finding
As reported in the abstract
Surgical bailout incidence
| Group | Value | 2007 to 2010 | 2019 to 2022 |
|---|---|---|---|
| Surgical bailout | 0.52% | 0.84% | 0.25% |
- Incidence decreased over time
- P for trend < 0.001
Further findings
| Outcome | Surgical bailout | No surgical bailout | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| 1-year all-cause mortality | 68.3% | 15.3% | 8.60 (6.74–10.97) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
Mortality in patients surviving the first 90 days (landmark) · beyond 90 days
- Similar mortality risk in 90-day survivors
- HR 2.19 (95% CI 0.91-5.27, P = 0.08)
Incidence of surgical bailout over time
- Incidence 2007 to 2010
- 0.84%
- Incidence 2019 to 2022
- 0.25%
- Trend
- P for trend < 0.001
Surgical bailout by sex
- Women vs men
- 0.61% vs 0.41%
- P
- P = 0.03
Reason for surgical bailout
- Ventricular perforation (most prevalent)
- 28.0%
Original publication
Surgical Bailout in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. Published 13 January 2025. doi:10.1016/j.jcin.2024.09.050
Summarised from the published abstract; every number is checked against it